When can women expect to see free HRT as promised?

Dr Monica Oikeh said the delay with the free HRT scheme was similar to issues with the free contraceptive scheme when the Government announced it was going to happen and there was little communication with those delivering the service.

Menopause treatment has been in the news for all the wrong reasons with women left disappointed by a failure to deliver free HRT as promised in January.

Everyone involved has pointed the finger at someone else along the chain, but the end result is no change from last year.

The one light in the whole sorry mess was the sight of menopausal swimmers chatting casually to RTÉ’s Primetime about the delays. 

A sea-change from the decades when menopause was somehow shameful and secret.

Women only know now that it will be introduced “as soon as possible”, according to the Department of Health.

It all looked so rosy when then health minister Stephen Donnelly set out Budget 2025 plans to provide €20m for free HRT from January.

Questions on payment of fees

Even then there were questions over why women would still have to pay GP and pharmacy fees but this was explained away as of no significance. 

However like many things it was not a problem until it was.

If fees were not charged as with the contraception scheme, Mr Donnelly said: “It would have to be limited on some grounds, be it age or something else.

“Alternatively, we could make it available to everybody and provide the medicines, patches, and devices for free but, for now, those without a GP card would pay their own GP costs.”

We recognise pharmacists will have to apply some charge because there is no margin for them from selling the product. 

Behind the scenes over the subsequent few weeks — and it was a very few weeks to introduce a national scheme — problems began to emerge.

The Irish Pharmacy Union (IPU) wrote to the Department of Health four times querying the fees, development of an IT system, built-in inequality, and practical changes.

As pharmacy fees are usually included in medication costs, they argued women would not see this as ‘free HRT’. Fees can vary from pharmacy to pharmacy.

The Irish Medical Organisation wrote to the HSE asking for information for their GPs. This was also not forthcoming. That could be because the HSE did not have the answers.

By early November the Health Insurance (Amendment) and Health (Provision of Menopause Products) Bill 2024 was passed in the Dail and Seanad.

This looked positive.

Secondary legislation not written yet

However Tom Murray, IPU president told the Irish Examiner secondary legislation “hasn’t even been written yet”.

That is unlikely to change soon with no government in sight yet.

GPs welcomed the proposals. Although Dr Monica Oikeh, a GP and menopause specialist working in Douglas in Cork, like many was not expecting the January deadline to work out based on the lack of information.

“That was the same thing when it came to the free contraceptive scheme,” the Cork GP said.

“The Government announced it was going to happen and there was little communication with the doctors that were going to be prescribing it and delivering the services.” 

A briefing document for Mr Donnelly indicates department officials think the delays are down to the pharmacists.

They described the hesitancy to reveal fees as “deeply concerning” and said they are investigating whether all such fees should be transparent.

The National Women’s Council has called for an explanation but so far nothing has been cleared up.

Will this be a priority for the next government or will it end on the shelf where health plans go to die? Somehow it seems unlikely women will let this go.